Pericarditis chest pain may be worsened when you lie down. While acute cases resolve within a few weeks, the symptoms can still interfere with your ability to sleep.

Pericarditis is a type of heart condition characterized by inflammation of the pericardium, a set of thin tissues that surround your heart.

Depending on the underlying cause, pericarditis may be a short-term issue, or it may be a chronic (long-term) problem. Acute pericarditis and related symptoms tend to last 1–3 weeks. Chronic cases may last 3 months or more.

In either case, pericarditis can cause chest pain, making it difficult to sleep at night. This is a dull or stabbing pain in the middle or left part of your chest that often has a quick onset and may be accompanied by pain in your shoulders, too.

Such discomfort from pericarditis pain can understandably keep you awake as you toss and turn in an attempt to find a comfortable position. If you’re looking to get better sleep with pericarditis, consider the following tips and information that may help you get a good night’s rest.

Acute pericarditis treatment often involves getting rest. This may be a challenge if you’re uncomfortable lying down. For difficulties with falling or staying asleep with pericarditis, you may first consider whether you’re lying down in the best position.

While lying down tends to worsen pericarditis pain and sitting up helps it, you can still adjust the way you lie down for sleep depending on your individual symptoms. Below are a few adjustments to consider.

On your right side

Pericarditis pain tends to occur in the middle to left side of your chest. In theory, lying on your left side could place more pressure against your heart, possibly worsening chest pain.

While there are blogs that describe this more anecdotally, the clinical evidence backing this sleeping position for pericarditis is lacking. But you can try sleeping on your right side on a trial-and-error basis to see if this helps.


If sleeping on your side isn’t comfortable, you may consider lying on your back with your head and neck elevated to possibly alleviate chest pain and shortness of breath from pericarditis.

While no clinical studies have tested this sleeping position for pericarditis, it’s thought that elevated sleeping positions may help improve breathing and chest pain related to other conditions, such as asthma (according to the Asthma and Respiratory Foundation) and pulmonary fibrosis (according to the Action for Pulmonary Fibrosis organization).

For this sleeping position, try placing multiple pillows or a wedge-shaped pillow to help elevate your head, neck, and shoulders. You might also find that placing a pillow under your knees may place less strain on your back.

You should try to avoid lying flat on your back with pericarditis. In general, lying down on your back can make pericarditis symptoms worse because this position may worsen acute chest pain.

But you may sleep on your back in an elevated position, especially if you have shoulder pain. Sometimes, pericarditis may cause pain in one or both of your shoulders. In theory, this could make it difficult to sleep on your side.

Sleeping on your stomach also isn’t advised because this may reduce air flow and worsen shortness of breath you might be experiencing from pericarditis.

In addition, try to avoid deep breathing as a way to calm yourself into sleep. While often a relaxation technique, taking deep breaths may worsen chest pain.

A doctor may recommend that you take over-the-counter (OTC) or prescription medications, such as:

These, which may be prescribed individually or together, can help reduce pain and inflammation with acute pericarditis, but they may also offer relief so you can sleep at night.

Other tips for sleeping with pericarditis include:

  • avoiding meals before bedtime
  • keeping your bedroom dark and cool
  • avoiding electronic devices before bed
  • relaxing activities an hour before bed, such as taking a bath, reading, or meditation (according to the Heart Foundation)
  • avoiding alcohol and stimulants like caffeine and sugar
  • sticking to a sleep schedule, including on weekends

The overall outlook for people with pericarditis depends on the underlying cause. These can include short-term illnesses or long-term conditions like autoimmune diseases.

Regardless, if you’re having a hard time sleeping on a regular basis, it’s recommended to speak with a doctor about your current treatment plan. Mild pericarditis usually clears up on its own, but you may need support if chest pain is causing sleep issues.

In the long run, chronic sleep issues can also increase your risk of heart difficulties. According to the Centers for Disease Control and Prevention (CDC), people who are chronically sleep deprived are more likely to develop heart disease, high blood pressure, and stroke.

You might also consider speaking with a doctor about the risk of developing chronic pericarditis if you recently received a diagnosis of an acute case.

It’s estimated that about 30% of people with acute pericarditis will experience a recurrence. A 2021 study argued that recurring pericarditis in a survey of 83 participants was linked with poor sleep quality, mental health conditions, and difficulty with working.

Finally, it’s suggested to speak with a doctor about your treatment plan. Researchers also continue to investigate new treatments for chronic and recurring pericarditis, as one 2022 study reported a phase 3 clinical trial of one such medication helped improve symptoms and sleep quality.

Pericarditis-related discomfort can undoubtedly interfere with your ability to fall and stay asleep. Here’s some key facts to know about sleep and pericarditis.

Is it hard to sleep with pericarditis?

Sitting up or bending forward can improve pericarditis chest pain. This is why you might find it hard to sleep when you lie down in bed.

Does pericarditis get worse at night?

It’s not clear whether pericarditis itself is worse at night. But it may worsen when lying down. You might also notice pain more at night due to the elimination of other stimuli.

What sleep position is best for pericarditis pain?

While there’s no single best sleep position for pericarditis, you may find that you have less chest pain when you sleep on your side. Finding the best sleep position can take some trial and error until you have found the most comfortable one for you.

Trying out different sleeping positions, taking OTC pain medications, and practicing good sleep hygiene are all strategies that may help. But if you still can’t sleep, consider speaking with a doctor. Getting rest is important for pericarditis recovery, as well as your overall health.